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MDMA (Ecstasy) Withdrawal Symptoms, Effects, and Timeline

person taking ecstasy in club

Ecstasy, also referred to as MDMA, Molly, or X, is classified as a stimulant and a hallucinogen by the Drug Enforcement Administration (DEA).1 It is a Schedule I drug with no currently accepted medical uses and a high risk for abuse.1 Molly is commonly misperceived to be pure MDMA, but capsules of Molly may contain other drugs.2

Ecstasy withdrawal symptoms can occur after the drug’s effects wear off, usually between 3-6 hours, and the effects can last for a week or longer in some cases.1, 2,3 Withdrawal symptoms are rarely life-threatening, but they can be uncomfortable and distressing. The characteristics of Ecstasy withdrawal may be affected by the use of other drugs with MDMA.2, 3

How Long Does Ecstasy Stay in Your System?

Withdrawal Treatment

doctor speaking with patientDrug withdrawal treatment, which prevents or eases symptoms caused by abrupt withdrawal of addicted substances, is the first phase of rehabilitation.

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Once a person takes a dose of MDMA/Ecstasy, they may feel the effects approximately 30-45 minutes later, and they generally last between 3-6 hours.1, 2 It is not uncommon for users to pair MDMA with other drugs, such as LSD or marijuana, to enhance and lengthen the effects.1, 2,3

Some people will take more than one dose or take additional doses over a period of time. Certain MDMA break-down products inhibit efficient processing of the drug, meaning that additional doses can lead to dangerously high concentrations.3

Even after the drug has worn off, people may continue to experience MDMA after-effects for a week or longer.1, 2, 3

Symptoms and Effects

frustrated couple in bedroomWithdrawal symptoms for Molly or Ecstasy involve physical and psychological effects, including:

  • Aggression.2, 3
  • Anxiety.2, 3
  • Decreased libido and pleasure from sexual activity.2, 3
  • Depression.2, 3, 4
  • Difficulty focusing or concentrating.4
  • Fatigue.4
  • Impulsivity.2, 3
  • Increased irritability.2, 3
  • Thirst.3
  • Issues with memory.2
  • Poor appetite.2, 3, 4
  • Sleep difficulty.2, 3

Coming down from Ecstasy can be affected by a variety of factors. These include:

  • The amount used.
  • How long it has been used.
  • Any other psychiatric or medical conditions.
  • The use of other drugs, such as alcohol or marijuana.

Identifying MDMA withdrawal symptoms can be complicated by the fact that other substances or combinations of substances can be present in what is sold as “pure” Ecstasy. These can include methamphetamine, cocaine, ketamine, dextromethorphan, caffeine, ephedrine, and bath salts.1, 2 Since Molly is not produced in regulated laboratories, most consumers are not aware of what additional substances may be in the pills they are using.

Length of Withdrawal

It can be difficult to pinpoint a specific Ecstasy withdrawal timeline due to the number of factors involved in coming down from MDMA. The use of other drugs, length of use, dose taken, presence of any adulterants in the Ecstasy, and medical or mental health issues can strongly influence the severity and length of withdrawal symptoms.

The withdrawal timeline can include symptoms lasting up to a week or even longer in some cases.

As the Ecstasy dose wears off, users may experience withdrawal symptoms within 3-6 hours of use, and these may peak over the first few days.1, 2, 3 The withdrawal timeline can include symptoms lasting up to a week or even longer in some cases.1, 2, 3

The symptoms listed above tend to dissipate slowly over the first week of sobriety, though users may feel certain symptoms for longer, such as confusion, depression, and issues with concentration, memory, and sleep.4 Symptoms such as agitation, sleep disturbances, irritability, thirst, poor appetite, and restlessness generally resolve within a week.3

Is Withdrawal Dangerous?

woman suffering from ecstasy withdrawal symptomsWithdrawal from MDMA is not as risky as withdrawal from some other substances, such as alcohol or benzodiazepines, which can be life-threatening. However, complications of Ecstasy or Molly withdrawal can include:

  • Anxiety. Withdrawal can cause anxiety, which can lead individuals to abuse other substances to relieve the anxiety.
  • Depression. People who are withdrawing from Ecstasy or Molly may experience feelings of sadness or even extreme depression. Those experiencing severe depression are at risk for suicidal thoughts or behaviors.
  • Decreased appetite. MDMA withdrawal can lead to reduced appetite, which may lead to some unhealthy weight loss and temporary nutritional deficiencies.
  • Insomnia. Users that develop insomnia from withdrawal may be at risk of accidents or injury.

MDMA and Molly increase the activity of dopamine, norepinephrine, and serotonin.2 These brain chemicals cause heightened energy and activity, euphoric feelings, raised heart rate and blood pressure, and changes in mood, appetite, sleep cycles, arousal, trust, and empathy.2

Following Ecstasy use, the brain becomes depleted of serotonin, which can lead to disturbances in mood, sleep, and appetite.3Those in withdrawal may be at a risk of relapse to avoid these uncomfortable or distressing symptoms.

The safest way to detox from MDMA is to find a detox program, an inpatient treatment facility, or outpatient treatment. Specialized medical and psychiatric staff in these programs monitor the safety and comfort of each person. Staff are trained to identify symptoms, and they can provide support, treatment, and medication to ease the withdrawal process.

Read next: Ecstasy Withdrawal Medications and Help

Sources

  1. Drug Enforcement Administration. (2015). Drugs of Abuse.
  2. National Institute on Drug Abuse. (2016). MDMA (Ecstasy/Molly).
  3. National Institute on Drug Abuse. (2006). MDMA (Ecstasy) Abuse.
  4. National Institute on Drug Abuse. (2016). Commonly Abused Drugs Charts.

MDMA (Ecstasy) Withdrawal Medication and Treatment

People who regularly use Ecstasy (also referred to as MDMA or Molly) may experience withdrawal symptoms when they try to stop using.2,6 Professional Ecstasy withdrawal treatment can help people deal with the symptoms as they work to become clean and sober.

Treatment programs may include detox centers, inpatient rehabs, and outpatient programs. Although there are no specific medications for Ecstasy withdrawal, physicians may prescribe other medications to help ease withdrawal effects, such as insomnia.

Detoxing cold turkey at home can be difficult because of the possibility of developing mental or physical health issues. The medical care and supervision available at treatment centers may help prevent or alleviate these problems.

Detoxing at Home

Importance of Detox

Man going through detox sits on steps and covers faceAddicts who are ready to begin the recovery process from drug and alcohol addiction usually must undergo detox, or medical detoxification, as the first step on the road to healing from substance abuse issues.

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Some users are tempted to detox at home and try to stop using cold turkey. Although Ecstasy withdrawal is not usually life-threatening, it can be challenging and pose a number of potential concerns, including: 

  • Aggressive behaviors.3
  • An increased chance of depression and a risk of suicide.5
  • An increase in anxiety or other mental health issues. 5
  • A risk of relapse due to cravings. Although cravings are uncommon, some users do experience them when they stop using.4

In addition, because Ecstasy or Molly is usually not pure and is often cut with other substances, such as cocaine or amphetamine, users may experience additional withdrawal symptoms associated with the combinations of these drugs.6  Some users may also use other drugs to help ease the withdrawal symptoms from Ecstasy, which can lead to further substance abuse.

Professional detox programs provide a safe and comfortable method of undergoing MDMA withdrawal. Not only will a person receive proper supervision and care to help them get through the withdrawal period as comfortably as possible, but detox programs also have qualified staff on hand who can treat any medical or mental health symptoms that may occur.

Detox and Withdrawal Treatment

The most common withdrawal treatment options include:

Therapist writes notes on detox treatment for male patient

  • Stand-alone detox centers. At a detox center, patients live at the facility throughout the detoxification process, receiving 24/7 monitoring and support. They are discharged after they complete withdrawal, and they may continue treatment for addiction at another facility.
  • Hospitals. Someone seeking treatment in a hospital will be treated in a specialized unit and receive 24/7 care and monitoring, much like a stand-alone detox center. Outpatient day treatment at a hospital offers support and monitoring but on a less intense basis.
  • Inpatient treatment. In this type of treatment program, people reside at the drug treatment center for a specified period of time. Many inpatient rehab centers provide 24/7 monitoring and medical care for detox as well as treatment for addiction, such as therapy and 12-step meetings.
  • Outpatient treatment. In this type of setting, people live at home but travel to an outpatient treatment facility to receive withdrawal care and monitoring for the length of the program.

It’s important to participate in a professional MDMA recovery program to address the addiction and treat abuse of any other drugs.

In most cases, the care a person receives at these facilities will include medical supervision and monitoring for withdrawal symptoms, such as depression and insomnia, and medication to treat these or other physical and psychological symptoms.

After completing detox, it’s important to participate in a professional MDMA recovery program to address the addiction and treat abuse of any other drugs. In many cases, people can attend an addiction treatment program at the same facility where they completed detox.

Medications

No specific Ecstasy withdrawal medications exist.6 However, certain supportive medications may be prescribed to treat symptoms. These medications may include:

  • Antidepressants to treat depressive symptoms.
  • Sleep aids to alleviate insomnia or other sleep disturbances.
  • Benzodiazepines to treat anxiety.
  • Fluids to treat dehydration, which is one of the primary risks of Ecstasy abuse.
  • Additional medications to treat other symptoms as deemed necessary by a person’s medical provider.

Read next: Ecstasy Withdrawal Symptoms, Timeline, and Effects

Sources

  1. Substance Abuse and Mental Health Services Administration. (2002). Ecstasy: What's all the rave about?
  2. Muskin, P. (2014). DSM-5 self-exam questions: Test questions for the diagnostic criteria. Washington, D.C.: American Psychiatric Publishing.
  3. National Institute on Drug Abuse. (2006). What are the effects of MDMA?
  4. Davis, A. and Rosenberg, H. (2014). The prevalence, intensity, and assessment of craving for MDMA/ecstasy in recreational users. Journal of Psychoactive Drugs, 46 (2), 154–161.
  5. Bhatia, S., Gabel, T., and Petty, F. (eds.) (2017). Substance and nonsubstance related addiction disorder: Diagnosis and treatment. Sharjah, UAE: Bentham Science Publishers.
  6. National Institute on Drug Abuse. (2016). MDMA (ecstasy, molly).
  7. Substance Abuse and Mental Health Services Administration. (2006). Quick guide for clinicians based on TIP 45—Detoxification and substance abuse treatment.
  8. National Institute on Drug Abuse. (2016). Treatment approaches for drug addiction.
  9. Center for Substance Abuse Research. (2013). Ecstasy.
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